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this post was submitted on 19 Feb 2024
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No Stupid Questions
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One thing that's different out that there is no such thing as not being able to pay for health insurance. You are required by law to be insured. This also means the government mostly covers it for you if you can't.
You may have to pay out of pocket for the first few hundred euros when something happens, but insurance covers the rest. There's no way a person's life savings would disappear overnight because of a medical issue. I'd rather die than pay what I sacrificed 30+ years to save up for.
That's similar to how it works in Democratic states in the US. It's more expensive, but there's no such thing as "not being able to afford insurance". It's required by law and subsidies make the premiums low for poor people. Although you may not have a huge choice in doctors, you will get medical care.
If anyone from the US complains, that they "can't afford insurance" ask them where they live. I guarantee that state is run by Republicans.
I make between 60-100k a year, (sorry, I know that's a wide range, but I rather not be specific) and I can't afford insurance worth having. The only plans without a 10k out of my pocket before they cover anything at all started at $450/ month. I ended up with a plan that covers nothing until I spend like 5 grand out of pocket. Just shy of $300/mo.
But, I live in a red state, so maybe you're not wrong. Private Insurance for healthcare is still an assinine idea in general high.
Do they offer a Health Savings Account? These high deductible plans should normally be paired with an HSA, and together they make a more reasonable choice.
I’ve actually been wanting to switch because I think I would save money. I have a more traditional plan right now and it’s very expensive but covers my family for most things, with a minor copay. For the same cost to me, I could get both a high deductible insurance plan and fund an HSA sufficiently to cover that high deductible. In years we use it all, it break even. However if we don’t use the full HSA, it builds toward future costs
This is wild, in the UK, if you were in an accident and needed years of surgeries, it will always be free. The cost of parking to visit the hospital will be the most expensive thing anyone ever gets billed for, and that will be around 10 dollars a day. We do pay income tax, but lower income earners pay less or none. Theres also sales taxes, and things like sugar, alcohol and nicotine are taxed quite highly as they can contribute to health problems. But it's all well worth it to never worry about medical costs. https://www.gov.uk/income-tax-rates https://www.gov.uk/government/news/sugar-tax-revenue-helps-tackle-childhood-obesity https://www.gov.uk/tax-on-shopping/alcohol-tobacco
Among the many problems we have in heading there is that vice taxes are implemented at the state and tribal (for tobacco) levels, so it’s impossible to have a consistent policy.
Cigarettes are a perfect example with a wide range of taxes depending on the state, and last I knew, sales on reservations were tax free.
Looking it up, I see
That is such a huge difference: how do you turn that into a national policy?
You can also lol at life expectancy by state and see how each values its citizens
How the heck can there not be an uproar at that life expectancy difference? How can some states keep following the same pattern despite such clear impact on life? Sure, a lot of it is likely poverty rates, but it’s the same set of policies, not just one particular vice tax
Edit: before anyone credits simply the tropical paradise of Hawaii for too much of that life expectancy, Washington, Minnesota, and Massachusetts are right up there without the weather advantage
The UK also has much higher income taxes. Comparing US and UK income taxes:
US income tax is ferarally controlled. I don't have exact numbers but increases in income tax for the highest earners should be able to fund a public healthcare system, at least for the lowest earners in the US.
https://taxsummaries.pwc.com/united-states/individual/taxes-on-personal-income https://www.gov.uk/income-tax-rates
Edit: There are also state income taxes, which vary for some reason, I'm sure theres also county and city based taxes as well, processing them must be a nightmare. Is the US just 52 countries in a trench coat?
It seems that way sometimes.
There’s variation between states as a form of competition. For example Texas might attract people by claiming no state income tax, whereas Massachusetts might attract people with 100% medical insurance coverage, best education, highest quality of life.
When someone compares income tax rates and claims US is lower, I really don’t believe it because I know there are many taxing entities that are all separate from each other. I have no idea what other countries’ tax situation is, but are you really picking a fair comparison, if your taxing model is simpler? I’m cynical enough to expect we’re probably worse off than a simple comparison would show
You're probably right about being worse off overall, just so much unnecessary complexity. We do have council tax here, but that depends on how big a house you live in and how expensive the area is to maintain for the council. And its a fixed rate per household, owed monthly while you're at the same address. But I know the councils get most of thier funding from the state budget and other income streams like selling land. Theres also national insurance too which I guess is like social security. https://www.gov.uk/national-insurance
I have no idea ehich one is better, or costs more, but the UK does seem to offer more in return. Admittedly I only see the bad news stories about the US so have no idea what its like "on the ground". I've been to Florida, New York and Vermont, so I see how states are very different places with different needs, understandible why theres not a lot of state unity on issues.
Yeah, I do want to say that nothing is as bad as our bad news highlights. Even all the crazy”Florida Man” stuff, at least some of that is from laws favoring transparency in the legal system over other places favoring privacy of the accused. A lot of the political craziness is just posturing for points. Gun violence may be twice that of other developed countries but it’s still pretty low and most people do not live in fear. Etc etc.
I’d even claim some of what you hear is good, in that it’s a good value to criticize your own society. That’s how we get better.
Then again, most of it is probably outrage headlines and clickbait.
HSAs are actually pretty good if you don't use healthcare. They allow you to invest $4K tax-free per year per person. You can use them for any medical expenses, including condoms, dental care, glasses, nasal spray, tampons, acne medicine, masks, sanitizer, mental health care, in-home caregiver services, and long term care. You are definitely going to use the money eventually, and you can invest it tax-free.
https://www.goodrx.com/insurance/fsa-hsa/hsa-eligible-expenses
For any people from the UK, "dental care" means a special doctor just for teeth. Yes, that's a thing.
In the UK you can invest £20,000 (25,000 USD) per year into a fully tax free ISA savings account. You can spend it on anything you chose at any time, and you will never need to spend any of it on healthcare against your will. https://www.gov.uk/individual-savings-accounts/how-isas-work
Dental care is free in the UK for under 18s, people who are pregnant or given birth in the last 12 months, or people on low income. https://www.nhs.uk/nhs-services/dentists/who-is-entitled-to-free-nhs-dental-treatment-in-england/
Also if you were to unfortunately become disabled and are unable to work, you will be supported fully for the rest of your life. These benefits are not based on previous taxes paid like in the US. https://www.gov.uk/financial-help-disabled https://www.gov.uk/pip/how-much-youll-get
Frankly I don't recall. They dropped on us they were self insuring with like two weeks of open enrollment left, I made a snap choice and bought my plan on the "marketplace".
You can afford insurance and still go bankrupt.
"Medical expenses directly cause 66.5% of bankruptcies, making it the leading cause for bankruptcy. Additionally, medical problems that lead to work loss cause 44% of bankruptcies"
Blue state cab be better..
But these stats are concerning. More herehttps://www.retireguide.com/retirement-planning/risks/medical-bankruptcy-statistics/#:~:text=Medical%20expenses%20directly%20cause%2066.5,loss%20cause%2044%25%20of%20bankruptcies.